Active NPI
Patricia A Murray, D.M.D. PH.D.
- Periodontics
- Santa Rosa, CA
National Provider Identifier
1295941474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 40863
- Practice address
- 1100 Sonoma Ave
Suite D
Santa Rosa, CA 95405-8901 - Phone
- (707) 525-1600
- Fax
- (707) 527-6686
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 40863 | CA | Primary |
Addresses
Primary practice location
1100 Sonoma Ave
Suite D
Santa Rosa, CA 95405-8901
Mailing address
1100 Sonoma Ave
Suite D
Santa Rosa, CA 95405-8901
Phone (707) 525-1600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 24, 2016 through Oct 24, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40863 | CA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295941474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 SONOMA AVE",
"address_2": "SUITE D",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954058901",
"telephone_number": "707-525-1600",
"fax_number": "707-527-6686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 SONOMA AVE",
"address_2": "SUITE D",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954058901",
"telephone_number": "707-525-1600",
"fax_number": "707-527-6686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURRAY",
"first_name": "PATRICIA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.M.D. PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "40863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.